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061 - <br /> C. OTHER SUBMITTAL REQUIREMENTS : <br /> 1 . Twenty--six (261) copies of the preliminary plat <br /> 2. Two full size copies of an Orange County Tax map (one co <br /> parcels involved clearly marked) . pY with tax <br /> 3. Where municipal or OWASA sewer is not available, a Letter from the Orange <br /> County Health Department certifying the proposed wastewater system for <br /> each lot . <br /> I , the applicant, hereby certify that the foregoing application is complete and <br /> accsrata . I understand that a $210.00 fee (subdivisions of 15 Lots or less) <br /> or a $370.00 fee (subdivisions of 16 Lots or more) is due at the time of <br /> application . A $5.00 per Lot fee is due at the time the final plat 9s <br /> presented for recordation . <br /> C-)91/M-012.tv Rtzpz1-- <br /> APPLICANT 'S SIGNATURE c� OWNER 'S SI URE <br /> _ 01/15/ 80 <br /> 01 /15/V, <br /> DATE DATE <br /> 11 <br /> II <br /> FEES: Amount Date Paid Receipt <br /> 1 <br />